This case involves elderly abuse at a nursing home. An eighty-nine-year-old female had been staying at a nursing home for four years, but, due to budget cuts and staffing changes, was assigned a new primary caretaker. The elderly plaintiff began complaining to her family that she was being hit by her new caretaker, but since she suffered from dementia, and no other residents or caretakers witnessed any abuse, the complaints were ignored. During one visit, her son noticed bruises on the elderly plaintiff’s arm and that she seemed to cower from the caretaker. The son was suspicious, and upon questioning the plaintiff again, found that the caretaker treated her roughly. The family confronted the caretaker directly, citing the elder’s bruises and fearful body language, but the caretaker claimed that the resident fell from her wheelchair. Still suspicious, the family filed a complaint to the nursing home and an investigation commenced. It was revealed that the caretaker had struck the plaintiff on at least six occasions.

Question(s) For Expert Witness

In your experience, what are the typical causes of elderly abuse in a nursing home setting, and what are some ways that nursing home administration can prevent this kind of abuse?

Expert Witness Response #

Staffing levels, resources, and quality vary between nursing homes, and no one factor is proved to cause abuse. However, there have been certain factors or combinations of factors that seem to correlate with nursing staff abuse. For example, cases of elderly negligence and abuse in nursing homes are often linked to understaffing. Like any organization, nursing homes have to cut overhead expenses from their budgets, and sometimes that results in diminished staff. However, since nursing and certified aides provide almost all of the patient care, when the staff is decreased, supervision of residents suffers, which usually has a negative effect on the quality of care the elders receive. Elder abuse tends to be more common in facilities with a high percentage of elders with dementia in conjunction with a low staff ratio. Also, aides that are poorly trained are not as likely to give quality care to residents with dementia and exhibit violent behavioral symptoms such as hitting or kicking residents. Quality of care suffers for these residents especially when the staff ratio is low and they are being asked to work double shifts. This seems particularly pertinent to this case, as the elder in question suffered from dementia and her nursing home recently cut its budget and fired staff. It is extremely important for nursing homes to maintain a healthy staff-resident ratio to cultivate a safe, friendly environment for residents. Well trained staff should be the top priority, and the last thing to be reduced in case of a budget cut.

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